The Level and Clinical Significance of Red Blood Cell Distribution Width in Patients With Congenital Heart Disease Associated With Pulmonary Hypertension.

Abstract

Previous studies have shown that red blood cell distribution width (RDW) is an independent risk factor for the prognosis of pulmonary arterial hypertension (PAH) and is also associated with cardiovascular events in patients with congenital heart disease (CHD). However, its role in patients with CHD-associated pulmonary hypertension (PAH-CHD) has not been reported. This study aimed to investigate the level and clinical significance of RDW in PAH-CHD patients. A total of 129 patients with CHD confirmed by right heart catheterization (RHC) were enrolled, including 109 PAH-CHD patients and 20 CHD patients without PAH. Cardiac ultrasound, blood biochemistry, and RHC hemodynamic data were collected and analyzed. The RDW level in the PAH-CHD group was significantly higher than that in the non-PAH-CHD group and the normal control group (p < 0.05). Using a cut-off value of 13.25% for RDW, the sensitivity and specificity for predicting severe PAH-CHD were 72.2% and 77.9%, respectively, with an area under the ROC curve of 0.798 (p < 0.001). RDW was significantly correlated with PAH risk stratification indicators (r = 0.54, p < 0.001). In conclusion, RDW levels are significantly elevated in patients with severe PAH-CHD, and a cut-off value of 13.25% demonstrates high predictive value for severe PAH-CHD. Therefore, RDW level could serve as an economical and practical indicator for assessing the condition and prognosis of PAH-CHD patients.